慢性阻塞性肺疾病患者红细胞分布宽度与BODE指数的相关性研究

发布时间：2018-06-26 06:18

  本文选题：慢性阻塞性肺疾病 + 红细胞分布宽度　； 参考：《山西医科大学》2017年硕士论文

【摘要】：【研究背景】目前慢性阻塞性肺疾病是严重威胁人类生命安全的第五大死亡原因,患病率高、就诊率低,具有较高致残和致死率。慢性阻塞性肺疾病以气流受限为特征,可以预防和治疗,与炎症反应有关。慢性阻塞性肺病对患者的影响可波及全身,肺功能仅能评价慢性阻塞性肺病患者肺部疾病进展的严重程度,但对于患者综合情况及预后的评估有很大的局限性。红细胞形态不仅反映血液系统疾病,也可反映机体的慢性炎症状态、全身营养状况、以及无效的红细胞生成。红细胞分布宽度(RDW)是客观表示红细胞形态学变化的指标。BODE指数综合了包括临床症状、营养状态、运动能力和肺功能的相关参数,可以综合评价慢性阻塞性肺病患者的综合情况并对预后有提示意义。【目的】探讨红细胞分布宽度与慢性阻塞性肺病患者BODE指数及病情严重程度间的相关性。【方法】1研究对象选择:选取2015年12月至2016年12月期间于山西医科大学第二医院就诊的慢性阻塞性肺病患者的病历进行研究。2指标分析:记录并统计其人口统计学特征,包括性别、GOLD分级、吸烟情况、合并症及BODE指数等。统计分析红细胞分布宽度与GOLD分级、功能参数、人口统计学参数等的相关性。对比分析不同RDW水平的患者的一般情况。3统计学分析:使用SPSS 19.0软件包对数据进行统计学分析,采用KolmogorovSmirov正态检验数据是否符合正态分布,计量资料采用均数±标准差((?)±s)表示,组间比较采用独立样本t检验,多组间比较采用方差分析。计数资料以百分比表示,采用χ~2检验。RDW与BODE指数的相关性采用Pearson相关分析。影响BODE指数的因素纳入多因素Logistic回归分析。P0.05认为差异或相关性有统计学意义。【结果】1所选取的研究对象男性占88%,女性占12%,GOLD分级集中分布在2、3级,,64%的患者有心源性疾病、糖尿病及其他并发症,所有患者的BODE指数均在0~10;2 GOLD分级1~4级患者的RDW差异有统计学意义(F=4.773,P=0.04),RDW随着GOLD分级升高而逐渐增大;3两组患者的年龄、FEV1、%FEV1、FVC、FVC%、FEV1/FVC、PEF、%FEF25/75、开始吸烟时间、BMI、6MWT、氧饱和度、BODE指数等均有显著差异(P0.05);和REW≤14.3的患者相比,RDW14.3的患者年龄、BODE指数显著增大(P0.05);FEV1、%FEV1、FVC、FVC%、FEV1/FVC、PEF、%FEF25/75、开始吸烟时间、BMI、6MWT、氧饱和度显著下降(P0.05);4 RDW与年龄、BODE指数、GOLD分级呈显著正相关(P0.05);RDW与6MWT、%FEV1、FVC%、FEV1/FVC、PEF%、%FEF 25/75、氧饱和度、BMI呈显著负相关(P0.05)。【结论】1 COPD患者多为男性、吸烟者、患有心源性疾病、糖尿病及其他并发症者、BODE指数在0~10;2 RDW与GOLD分级2、3级的患者呈显著正相关;3年龄、FEV1、%FEV1、FVC、FVC%、FEV1/FVC、PEF、%FEF 25/75、开始吸烟时间、BMI、6MWT、氧饱和度、BODE指数均可影响RDW大小;4 RDW与年龄、BODE指数、GOLD分级呈显著正相关;与6MWT、%FEV1、FVC%、FEV1/FVC、PEF%、%FEF 25/75、氧饱和度、BMI呈显著负相关。
[Abstract]:Background at present, chronic obstructive pulmonary disease (COPD) is the fifth leading cause of death, which is a serious threat to human life. Chronic obstructive pulmonary disease, characterized by airflow limitation, can be prevented and treated, and associated with inflammation. The influence of chronic obstructive pulmonary disease (COPD) on patients can affect the whole body. Pulmonary function can only evaluate the severity of pulmonary disease in patients with chronic obstructive pulmonary disease (COPD), but it has great limitations in the evaluation of patients' comprehensive condition and prognosis. Erythrocyte morphology not only reflects the disease of the blood system, but also reflects the chronic inflammatory state of the body, the nutritional status of the whole body, and the ineffective erythropoiesis. Red blood cell distribution width (RDW) is an objective indicator of red blood cell morphological changes. The bode index synthesizes the related parameters including clinical symptoms, nutritional status, motor ability and lung function. [objective] to investigate the correlation between erythrocyte distribution width, bode index and severity of chronic obstructive pulmonary disease (COPD). [ Methods: 1 the study subjects were selected from the second Hospital of Shanxi Medical University from December 2015 to December 2016. The medical records of patients with chronic obstructive pulmonary disease (COPD) from December 2015 to December 2016 were analyzed. These include gender gold grade, smoking status, complications and bode index. The correlation between red blood cell distribution width and gold grade, functional parameters and demographic parameters was analyzed statistically. Comparing and analyzing the general situation of patients with different RDW levels. 3 statistical analysis: the data were analyzed by SPSS 19.0 software package. Kolmogorov Smirov normal test data were used to test whether the data accorded with normal distribution. The measurement data were expressed as mean 卤standard deviation (?) 卤s). Independent sample t test was used for group comparison and ANOVA was used for multi-group comparison. The count data were expressed as percentage, and Pearson correlation analysis was used to analyze the correlation between RDW and bode index by 蠂 ~ 2 test. The factors influencing bode index were included in multivariate logistic regression analysis. P05 suggested that the difference or correlation was statistically significant. [results] 1 the selected subjects were 88 males and 12 females who had cardiogenic diseases in 64% of the patients with grade 2 or 3 grade gold. Diabetes and other complications, There was a significant difference in RDW in all patients at 0 / 10 / 2 gold grade / grade 1 / 4 (F = 4.773 / P0. 04). The age of FEV1, V1FVCCFVCV, F2575, BMI6MWTT, oxygen saturation and BODE index increased gradually with the increase of gold grade in all patients. There was significant difference (P0.05); the age and BODE index of patients with RDW14.3 increased significantly compared with those of patients with REW 鈮，

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